I posted on the following blood test results on the forum back in December as I have been suffering from very achy arms for over a year (2 years 3 months on Levo for hypothyroidism, already treated for Vit D) and want to know if this could be the result of thyroid issues.

December thyroid results:

Serum TSH = 4.22 mU/L (0.35-5.00)

Free T4 = 15.6 pmol/L (9.0-19.1)

It was recommended by volunteers on the forum that I ask my GP for an increase in Levo dose (I'm currently on 100mgs) showing him the Toft article as the TSH was at the top end of the normal range and it should be below 1, ideally. (I had asked him before this result for an increase based on my symptoms but he said no.)

Anyway, I decided it might be a good idea to get a private, more comprehensive test done first to see if I have a T3 conversion issue or if any other problems show up which might convince him to adjust or change my meds.

The results from this are as follows. Everything else seems normal except the antibodies. The TSH seems lower but the measuring unit and ranges are different so it's hard to tell. Though what does the positive last result mean? Is that significant even given that I have a known thyroid condition and am already on Levo?

TSH: 1.91 mIU/L (0.27 - 4.2)

Free Thyroxine 18.8 pmol/l (12.0-22.0)

Total Thyroxine (T4) 99 nmol/L (59-154)

Free T3 4.8 pmol/L (3.1-6.8)

Thyroid Antibodies:

Thyroglobulin antibody 24.2 IU/mL (0-115 ) (Negative)

Thyroid Microsomal Ab (Conf) Positive - Titre of 1 in 25,600

"We advise that you discuss with your doctor."

I would be interested in any reactions to this so I am forearmed before going back to the GP. If everything is totally normal I could have difficulty persuading him my symptoms are thyroid related...

Although your test results look 'normal' the problem is you don't feel normal. If your GP knew exactly what was normal for you then he could say normal but since he does not he should be listening to how you feel.

You could easily have an increase as your TSH is still high even at 1.91 and your fT4 is not over the limit at all. Ask your GP for a trial increase and retest to see if that makes him 1 relent and 2 make a difference to you.F

From looking on the web that test result for antibodies says you have autoimmune condition causing your thyroid issues (as do I and loads of people on here).

Have you had your iron tested? B12 etc? How is your body temperature? What is your BP and pulse like? When did you take your medication before the test? Do you take any supplements and is your Vit D fixed now/ been retested since treatment?

Thanks for your reply. OK, here are some more results to answer your questions:

In May my Vitamin D was 10.7 ug/L (10-20 = insufficient) but I have been on prescribed supplements since then and last time it was tested in August was 41.4. I decided to add a loading dose myself (from end October for 3 months) to the prescribed supplements to get to a normal level quickly as I was borderline deficient originally, and I had read that a loading dose is often prescribed in these cases.)

Re Iron, in April my Serum Ferritin was 17mg but the doc was unconcerned but agreed to re-test in December in case it was on the way down. In December my Serum Ferritin was 30microg/l (15-300).

I take my Levo at night so 10 hours approx before I'm usually tested (8.30-9am). I have been taking several supplements in the morning including magnesium from early Dec and just recently adding selenium.

My Vit B12 was 361ng/L (130-900) in April & I have been supplementing myself since end Nov as I wasn't convinced it was adequate.

In December Calcium was 2.28 nmol/L &

Adjusted Calcium (2.33 nmol/L (2.20-2.60).

I don't take my temp regularly but body temperature is normal tonight. It was low a couple of weeks ago though (97 if I recall).

Doc said in Dec my pulse was normal.

What is the significance of having an autoimmune thyroid condition? I'm not surprised that this is the case as I've had other autoimmune conditions over the years eg ideopathic, chronic urticaria for 20 years, and post nasal drip. I still have a food intolerance with a cough (diagnosed as salicylate intolerance - but I'm not convinced by this explanation).

I asked the doc in December if I could have a trial increase of Levo but he said no. Do you think the autoimmune result above adds weight to my case or would he already be aware that this is the cause of my thyroid problems? He's certainly never mentioned it what has caused it, but perhaps he hasn't a clue...

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Your iron is still low. It may well have a bearing on how you are feeling as it will need to be much higher for you to be able to use the thyroid medication effectively. Mine was 14 when I had mine done and was told it was normal. Scale of 10-291 is so wide that the vast majority of people would fall into it but again it doesn't mean it is normal for you. I would certainly be looking at supplements here, I buy mine from Amazon as I have given up arguing with the Dr that I need to get my iron up.

Your vit D sounds like just how my dr treated it. *shakes head* I think you were definitely right to start treating it yourself. Have you had it retested recently as this can have a significant bearing on how your muscles feel. Your B12 was low too so hopefully that has now increased.

I don't fully understand the implications of the autoimmune aspect of it. I know that it means that your thyroid is not going to recover and that eventually it will stop working completely. I do know that it can mean fluctuations in the results and that medicating it can help with this. I have read about problems with having the antibodies in general but I have to say I really don't understand them. I have never been retested since testing positive and mine were really high. I also have other auto immune conditions.

During both the tests did you take your levo at night?

Can you see a different GP and see if they will allow an increase? If not can you ask to be referred to an endo so they 'can take responsibility' for increasing your medication? It is awful to be at the mercy of a GP who seems so stuck in their ways.

I haven't had my Vit D tested again or my other vitamins as I'm sure my doc thinks I'm neurotic. I think you're right that I should add iron to my supplements and will look into that as I know I won't get it from the doc.

Also, I would like to find out if there is a good endo in South Wales I could try and persuade the doc to send me to. (Is there someone I can email on this site?) I really don't want to end up with one who is as stuck in his ways as my doc. Like everyone else on this site I need someone who will treat symptoms not just go by the Holy TSH test... In the meantime he's put me on a waiting list to see a rheumatologist but I'm not sure if this person will be interested in the fact I'm hypothyroid. It would be great if he/she knows his/her stuff and recommends an increase himself but it could be weeks before that appointment.

Have a look at the hospital tab and see if there is anyone that can be recommended at your hospital or one near you.

Unfortunately, by experience, you have to show willing by having various other tests, seeing other drs before the GP may consider the elephant in the room that is the thyroid. I am now fully well but went through a right old time of it. I do not take my health for granted now and am very pro active.

Hmm, that's a good point about seeing other specialists first. It backs up what the 2 women in the petition to the Scottish Parliament were saying - that SO much money is being wasted by sending people round the houses because doctors are avoiding considering the thyroid as being at the root of the problem. (I should consider myself lucky perhaps that at least I have an initial diagnosis.)

I've already seen a physio (and am waiting to see a rheumy). I knew that was a waste of time as I've never thought my elbow problems and paresthesia were the result of a mechanical injury. (Both arms are involved with the 2nd one starting up a few months after the first).